神经刺激仪辅助罗哌卡因阻滞麻醉用于老年下肢手术的效果

Clinical Effect of Nerve Stimulator Assisted by Ropivacaine Block Anesthesia in Senior Patients Undergoing Lower Limb Surgery

目的观察神经刺激仪辅助罗哌卡因阻滞麻醉用于老年下肢手术的临床效果。方法将我院拟行单侧下肢手术的老年患者58例随机分为试验组30例和对照组28例。试验组在神经刺激仪引导下采用0.50%罗哌卡因和1.00%利多卡因行腰丛神经联合坐骨神经阻滞麻醉;对照组采用2.00%利多卡因和0.75%罗哌卡因行硬膜外麻醉。比较两组一般情况、麻醉情况、术后禁食及并发症情况。结果两组手术时间及使用止血带时间比较差异无统计学意义(P>0.05)。术中试验组平均动脉压保持在稳定的状态,无明显波动。手术开始时、术中不同时点及术后1 h平均动脉压两组比较差异有统计学意义(P<0.01)。麻醉开始起效时间、维持时间两组比较差异亦有统计学意义(P<0.05)。试验组麻醉后不同时点神经阻滞完善率均高于对照组,但差异无统计学意义(P>0.05)。术后禁食时间及尿潴留发生率两组比较差异有统计学意义(P<0.05)。结论在神经刺激仪定位下0.50%罗哌卡因用于老年下肢手术腰丛神经联合坐骨神经阻滞麻醉效果满意且安全性好。

Objective To investigate the clinical efficacy of nerve stimulator assisted by Ropivacaine block anesthesia in senior patients undergoing lower limb surgery.Methods 58 senior patients undergoing elective unilateral lower limb surgery were randomly divided into experimental group（30 cases） and control group（28 cases）.In experimental group,lumbar plexus combined with sciatic nerve block anesthesia was performed by a nerve stimulator with 0.50% of Ropivacaine and 1.00% of Lidocaine.In control group,epidural anesthesia was performed with 2.00% of Lidocaine and 0.75% of Ropivacaine.The general situation,anestesia situation,absolute diet time and complications were compared.Results There was statistically significant difference in the surgery time and tourniquet time between the two groups（P〉0.05）.The average arterial pressure of experimental group remained in a fairly stable state,and no obvious fluctuation was found.The beginning of surgery,different time points of surgery and 1 h after surgery,the average arterial pressure was significantly different between the two groups（P〈0.01）.There was obvious statistical significance in anesthesia onset time and duration between the two groups（P〉0.05）.Different time points after anaesthesia,the improvement rate of anesthetic block of experimental group was higher than that of the control group,but there was not statistically significant difference（P〈0.05）.Postoperative fasting time and incidence of urinary retention were significantly different between the two groups（P0.05）.Conclusion By means of a nerve stimulator,the satisfactory effect and higher safety can be achieved on lumbar plexus combined with sciatic nerve block anesthesia with 0.50% of Ropivacaine in senior patients undergoing lower limb surgery.